Amend HB 1366 (second reading engrossment) as follows: (1) Add the following appropriately numbered section: SECTION . Subchapter H, Chapter 301, Occupations Code, is amended by adding Section 301.354 to read as follows: Sec. 301.354. NURSE FIRST ASSISTANTS; ASSISTING AT SURGERY BY OTHER NURSES. (a) In this section, "nurse first assistant" means a registered nurse who: (1) has completed a nurse first assistant educational program approved or recognized by an organization recognized by the board; and (2) is either: (A) certified in perioperative nursing by an organization recognized by the board; or (B) recognized by the board as an advanced practice nurse and qualified by education, training, or experience to perform the tasks involved in perioperative nursing. (b) Unless the person is a nurse first assistant, the person may not use: (1) the title "nurse first assistant" or "registered nurse first assistant"; (2) the abbreviation "R.N.F.A."; or (3) any other title or abbreviation that implies to the public that the person is qualified as a nurse first assistant under this section. (c) A health maintenance organization or an insurer, including an insurer offering a preferred provider benefit plan, may not, by contract or any other method, require a physician to use the services of a nurse first assistant. (d) A nurse who is not a nurse first assistant may assist a physician, podiatrist, or dentist in the performance of surgery if the nurse: (1) assists under the direct personal supervision and in the physical presence of the physician, podiatrist, or dentist; (2) is in the same sterile field as the physician, podiatrist, or dentist; (3) is employed by; (A) the physician, podiatrist, or dentist; (B) a group to which the physician, podiatrist, or dentist belongs; or (C) a hospital licensed or owned by the state; and (4) is qualified by education, training, or experience to perform the tasks assigned to the nurse. (e) A patient or third-party insurer may not be billed separately for the services performed by a nurse described by Subsection (d). (f) A registered nurse must perform circulating duties in the operating room. In accordance with approved medical staff policies and procedures, a vocational nurse or surgical technologist may assist in circulating duties under the direct supervision of the registered nurse. (2) Strike Section 6 of the bill (page 6, line 9) and substitute the following appropriately numbered section: SECTION . Sections 301.1525, 301.1526, 301.1527, and 304.010, Occupations Code, are repealed. (3) Renumber the sections of the bill accordingly.